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Background Check Form

Background Check Form

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15Questions

HIPAA

Compliance

  • 1

    I understand that a review of my background may be performed in connection with my application for employment with Madison College (aka Madison Area Technical College, MATC-Madison).  This review may include a review of state and or federal court and other public records, verification of employment, compensation, education, and employment information, and a review of personal and professional references, in connection with my application for employment.  I hereby give permission to Madison College and its agents to conduct such a review.  I understand that my employment is contingent upon Madison College's satisfaction with the results of the review process.

    To the best of my knowledge, the information provided in this online form is accurate and complete.

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    • Belize
    • Benin
    • Bermuda
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    • Bosnia and Herzegovina
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    • Brazil
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    • Qatar
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    • Romania
    • Russia
    • Rwanda
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    • Saint Helena
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    • Saint Lucia
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    • Saint Vincent and the Grenadines
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    • Saudi Arabia
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    • Somaliland
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    • Tunisia
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    • United Kingdom
    • United States
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    • Vietnam
    • British Virgin Islands
    • Isle of Man
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    • Wallis and Futuna
    • Western Sahara
    • Yemen
    • Zambia
    • Zimbabwe
    • Other
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    By signing below, I authorize any person, present or former employer, educational institution, or law enforcement agency having any personal knowledge or information about me, to furnish such information to Madison College or its agents in connection with their review of my application for employment with Madison College and I release Madison College, and any such supplier of information, from any liability for supplying or collecting such information.
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